Convulsions induites par la ropivacaïne lors d’un bloc au canal huméral

Ould-Ahmed, Mehdi; Drouillard, I.; Fourel, D.; Roussaly, P; Almanza, Laura Herrera; F, Segalen

doi:10.1016/s0750-7658(02)00699-8

Cited by 15 publications

(2 citation statements)

References 20 publications

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“…17 This concentration is also in the range of those (2-6 μg/mL) measured between 0 and 60 minutes after ropivacaine overdose-related convulsions after brachial plexus blocks. [18][19][20] Finally, a mild preeclampsia state may have caused a decreased seizure threshold in this patient.…”

Section: Discussionmentioning

confidence: 80%

Convulsions in 2 Patients After Bilateral Ultrasound-Guided Transversus Abdominis Plane Blocks for Cesarean Analgesia

Weiss

Jolly²,

Dumoulin

et al. 2014

Regional Anesthesia and Pain Medicine

106

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These cases cast a cautionary note for the use of TAP blocks after cesarean delivery. The risk of systemic local anesthetic toxicity after this procedure remains unknown in this population and plasma concentration of local anesthetics should be measured in case of suspected toxicity. To limit this risk, a low concentration of local anesthetic solution should be chosen when a "20 mL bilaterally" regimen is necessary to achieve the required spread for a successful block.

show abstract

Section: Discussionmentioning

confidence: 80%

Convulsions in 2 Patients After Bilateral Ultrasound-Guided Transversus Abdominis Plane Blocks for Cesarean Analgesia

Weiss

Jolly²,

Dumoulin

et al. 2014

Regional Anesthesia and Pain Medicine

106

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“…According to several previous reports of ropivacaine overdose toxicity (see Table 1), the total dose of ropivacaine administered for brachial plexus block was 4.28-8.00 mg·kg −1 [13,[17][18][19][20]. These cases all occurred between 10 and 20 min after the brachial plexus block.…”

Section: Discussionmentioning

confidence: 94%

Ropivacaine-induced toxicity with overdose suspected after axillary brachial plexus block

et al. 2007

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Ropivacaine has a high threshold for systemic toxicity. We report and highlight a rare case in which an overdose of ropivacaine was suspected of leading to a generalized convulsion following the injection of this agent for axillary brachial plexus block (ABPB). A 25-year-old woman (height, 153 cm; weight, 48 kg; American Society of Anesthesiologists physical status I) was scheduled for finger surgery with ABPB. The perivascular sheath was identified by fascial clicks. We administered 300 mg (6.25 mg x kg(-1)) ropivacaine, while confirming that no blood flow was observed in the injection line by repeated negative aspiration tests. Ten minutes after the injection, most sensory and motor nerves were blocked effectively. Thirteen minutes after the administration, the patient lost consciousness and convulsed suddenly. No severe symptoms of cardiovascular toxicity occurred. The concentration of ropivacaine in a venous blood sample taken 28 min after the ropivacaine injection was 3.65 microg x ml(-1). She recovered with no sequelae. Limited cases have indicated high efficacy and sufficient safety for the use of 300 mg ropivacaine for ABPB. However, the toxic threshold of ropivacaine remains unclear, and the dose should be calculated in relation to the weight of the patient to prevent severe toxic complications.

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Ropivacaine

2006

Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions

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Convulsions induites par la ropivacaïne lors d’un bloc au canal huméral

Cited by 15 publications

References 20 publications

Convulsions in 2 Patients After Bilateral Ultrasound-Guided Transversus Abdominis Plane Blocks for Cesarean Analgesia

Convulsions in 2 Patients After Bilateral Ultrasound-Guided Transversus Abdominis Plane Blocks for Cesarean Analgesia

Ropivacaine-induced toxicity with overdose suspected after axillary brachial plexus block

Ropivacaine

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